Take the Treatment quiz.

Pills that help return the blood sugar (plasma glucose) to the normal range

Pills that increase the secretion of insulin from the pancreas

Insulin

All of the above

All of the answers are correct. However, the best answer is "All of the above". There are many different treatments for type 2 diabetes mellitus. Every treatment regimen starts with lifestyle changes - a healthy diet, adequate activity/exercise, and, as needed, losing weight. If lifestyle changes are not sufficient to control the blood sugar, then medications are added. Usually the first medication to be added is Metformin (a biguanide). It helps to return the blood sugar (plasma glucose) back to the normal, non-diabetic range. Other medications, including insulin, may be added to the metformin and lifestyle therapy. There is not a single treatment plan that is best for everyone. Talk with your provider about the best treatment plan for you.

Metformin (a biguanide):

Is a treatment for type 2 diabetes

Is the most widely prescribed medication for type 2 diabetes worldwide

Helps return the blood sugar (plasma glucose) to the normal or non-diabetic range

Works to reduce the liver production of sugar (glucose)

CANNOT be used if someone has kidney problems, severe heart failure and other serious medical problems, or drinks too much alcohol.

Has diarrhea or stomach cramping as a common side effect

All of the above

All the answers are correct. However, the best answer is "All of the above." Metformin (a biguanide) is the most widely prescribed medication for type 2 diabetes worldwide. It acts by reducing the production of sugar (glucose) from the liver, and thereby helps return the blood sugar (plasma glucose) to the normal, non-diabetic range. It cannot be used if someone has kidney problems, severe heart failure or other serious medical problems, or drinks too much alcohol. Diarrhea and stomach cramping are common side effects.

If you have type 2 diabetes and are treated with a medicine, you will be on that same medicine for the rest of your life:

True

False

False! If you have type 2 diabetes your medication may change over time. In general, most people will need higher doses and different kinds of medication over their lifetime - but not everyone. Some individuals may be able to go off medications all together, especially if lifestyle changes are very effective. Some people may temporarily need additional medication, including insulin, during times when they are sick, inactive or in the hospital. Women with diabetes may require insulin only when they are pregnant.

If you have type 2 diabetes, you may be treated with:

A single medicine

Multiple medicines

Oral medications (pills) as well as injected medications

Oral medications and insulin

Insulin alone

All of the above

All of the answers are correct. However, the best answer is "All of the above". There are many different treatments for type 2 diabetes. The treatment ranges from a single pill to multiple pills (oral medications), to pill(s) plus injected medicines including insulin, to insulin alone. Talk with your medical provider about what is the best treatment for you.

If you have type 2 diabetes and are treated with insulin:

The insulin is ALWAYS given once a day

The insulin is ALWAYS given as multiple daily injections

You do NOT have to match the insulin dose to the amount of sugar and starch in your diet

You should NOT be treated with an insulin pump

There are many different ways the insulin may be prescribed - the insulin dose regimen should match your specific needs.

There are many different ways the insulin may be prescribed - the insulin dose regimen should match your specific needs. Insulin may be given once a day, many times a day, or even via an insulin pump. It may also be given as a single therapy, or together with other diabetic medications. To reduce the risk of a low blood sugar (hypoglycemia), your insulin dose should be matched to the amount of carbohydrate in your diet.

You are at risk of a low blood sugar (hypoglycemia) if you are treated with any pills that increase the release of insulin from the pancreas or with insulin:

True

False

True! You are at risk of developing a low blood sugar (hypoglycemia) whenever you are treated with insulin or with medicines that increase the release of insulin from the pancreas. Once the insulin dose is injected under your skin, there is no way to change how much insulin is getting into your blood stream. The dose you are prescribed tries to approximate your needs, but because it is an approximation, you are always at risk of having too much insulin effect or too little. Similarly, the pills that cause insulin to be released from the pancreas increase insulin secretion, whether you need it or not. When there is a mismatch of circulating insulin with need, you may have a low blood sugar (hypoglycemia).

People taking the GLP-1 analogs, exenatide and liraglutide:

May experience some weight loss

May need to reduce the dose of their insulin releasing pill

May experience some nausea and vomiting when they first start taking the medicine

Should contact their doctor if they experience severe abdominal pain that won't go away

All of the above

All the answers are correct, but the best answer is "all of the above". People taking GLP-1 analogs may experience some weight loss. People taking GLP-1 analogs may need to reduce the dose of their insulin releasing pill to prevent low blood sugars. Common side effects of GLP-1 analogs are nausea and vomiting. People taking GLP-1 analogs should contact their doctor if they experience severe abdominal pain that won't go away because this can be a sign of an uncommon but life threatening side effect called pancreatitis.

DPP-4 inhibitors like saxagliptin and sitagliptin:

Are usually used in combination with other diabetes medicines

Are incretin based medicines that are taken as pills once daily

Do not cause weight loss, but also do not cause weight gain

Help control the blood sugar by increasing insulin release and lowering glucagon levels

All of the above

All the answers are correct, but the best answer is "all of the above". DPP-4 inhibitors can be used as first line treatments for diabetes, but they are usually used as second or third line options. DPP-4 inhibitors are pills that are taken by mouth. Unlike the GLP-1 analogs, DPP-4 inhibitors do not cause weight loss. However, they also do not cause weight gain. DPP-4 inhibitors work by lowering glucagon levels after meals to reduce the amount of sugar released from the liver and by increasing insulin release from the pancreas after meals when the blood sugar becomes too high.